Q: Portacath or Hickman Line, madam?

A 6 year old girl with Acute Lymphoblastic Leukaemia presents with another episode of febrile neutropenia with positive blood culture from her Hickman line. On a ward round, her parents discuss that they would like her to have a Portacath device inserted so that she can go swimming and is more comfortable around her friends. They are worried that she will be more susceptible to infection as the device is just below the skin and would like to avoid further hospital admissions. They ask if the portacath will increase her risk of infection during her remainder of her treatment?Fully implanted Port-a-caths have become very frequently used in my neck of the woods, but like many things, just because we do something doesn’t necessarily mean it’s the right something. Are ports really better than Hickman lines, or just more modern & fashionable? The question has been posed by Dr Natasha Alexander of St Mary’s Hospital, London and for me at least it will be good to know the answer.